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Transarterial chemoembolization for hepatocellular carcinoma: quality of life, tumour response, safety and survival comparing two types of drug-eluting beads

  • Interventional Radiology
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To compare two different types of drug-eluting microspheres with regard to impact on HRQoL after first TACE, tumour response, peri-procedural complications, adverse events and 1-year survival in patients suffering from unresectable hepatocellular carcinoma (HCC).

Methods

HRQoL was prospectively assessed with validated questionnaires (EORTC QLQ-C30 and -HCC18) before and 2 weeks after treatment with their first drug-eluting beads (DEB-)TACE with either acrylamido-polyvinylalcohol-AMPS hydrogel microspheres (groupDCB; 20 patients) or polyvinyl alcohol-co-acrylic acid microspheres (groupHS; 16 patients). Baseline characteristics, peri-procedural complications, treatment-related adverse events and 1-year survival were compared between both types of microspheres. Treatment response and objective response rates (ORR) were analysed using established tumour response criteria. Subgroup analysis for pooled groups with small (groupSMALL; 21 patients) versus large particles (groupLARGE; 15 patients) was performed.

Results

At baseline, there were no significant differences between the treated microsphere groups. No significant differences were found in absolute HRQoL changes after first DEB-TACE between the different types of microspheres. Response rates and survival were comparable between the investigated microsphere groups. For groupSMALL, we found a significant difference in post-interventional deterioration of physical function (− 19.4%) compared to groupLARGE (− 8%; p = 0.025). Tumour response and ORR according to mRECIST were significantly higher in groupSMALL (p = 0.008; p = 0.009).

Conclusion

DEB-TACE is generally well tolerated and effective, with comparable changes in HRQoL for both types of drug-eluting microspheres. Tumour response is better with small microspheres. A relevant deterioration of physical function underlines that an aggressive TACE using small beads should be well deliberated.

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Abbreviations

AFP:

Alpha-fetoprotein

AST:

Aspartate aminotransferase

ALBI:

Albumin-Bilirubin

ALT:

Alanine aminotransferase

BCLC:

Barcelona Clinic Liver Cancer

BMI:

Body mass index

CPS:

Child–Pugh score

CR:

Complete response

CRP:

C-reactive protein

DEB:

Drug-eluting bead

EASL:

European Association for the Study of the Liver

EORTC:

European Organisation for Research and Treatment of Cancer

GHS:

Global health status

HBV/HCV:

Hepatitis B/C virus

HCC:

Hepatocellular carcinoma

(HR)QoL:

(Health-related) quality of life

MELD:

Model of End Stage Liver Disease

mRECIST:

modified Response Evaluation Criteria in Solid Tumours

ORR:

Objective response rates

OS:

Overall survival

PD:

Progressive disease

PR:

Partial response

RFA:

Radiofrequency ablation

SD:

Stable disease

(c)TACE:

(conventional) Transarterial chemoembolization

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Author notes

  1. Jan B. Hinrichs and Thomas Rodt have contributed equally to this work.

Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany

    Janek Grumme, Thomas Werncke, Timo C. Meine, Lena S. Becker, Sabine K. Maschke, Frank K. Wacker, Bernhard C. Meyer, Jan B. Hinrichs & Thomas Rodt

  2. Department of Diagnostic and Interventional Radiology, Johannes Gutenberg-University Medical Centre, Mainz, Germany

    Roman Kloeckner

  3. Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany

    Martha M. Kirstein & Arndt Vogel

  4. Institute for Diagnostic and Interventional Radiology, Klinikum Lüneburg, Lüneburg, Germany

    Thomas Rodt

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The authors of this manuscript declare relationships with the following companies: Siemens Healthcare and ProMedicus (Bernhard Meyer and Frank Wacker; outside the submitted work). The remaining authors declare no relationships with any companies whose products or services may be related to the subject matter of the article.

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Grumme, J., Werncke, T., Meine, T.C. et al. Transarterial chemoembolization for hepatocellular carcinoma: quality of life, tumour response, safety and survival comparing two types of drug-eluting beads. Abdom Radiol 45, 3326–3336 (2020). https://doi.org/10.1007/s00261-019-02349-w

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